Strategic Plan 2020 to 2025

Delivering high-quality whole-of-life care to our community

© Commonwealth of Australia 2020

July 2020 / INFRASTRUCTURE 4260

Ownership of intellectual property rights in this publication

Unless otherwise noted, copyright (and any other intellectual property rights, if any) in this publication is owned by the Commonwealth of Australia (referred to below as the Commonwealth).

Disclaimer

The material contained in this publication is made available on the understanding that the Commonwealth is not providing professional advice, and that users exercise their own skill and care with respect to its use, and seek independent advice if necessary.

The Commonwealth makes no representations or warranties as to the contents or accuracy of the information contained in this publication. To the extent permitted by law, the Commonwealth disclaims liability to any person or organisation in respect of anything done, or omitted to be done, in reliance upon information contained in this publication.

Creative Commons licence

With the exception of (a) the Coat of Arms; and (b) the Department of Infrastructure, Transport, Regional Development and Communications’ photos and graphics copyright in this publication is licensed under a Creative Commons Attribution 4.0 Australia Licence.

Creative Commons Attribution 4.0 Australia Licence is a standard form licence agreement that allows you to copy, communicate and adapt this publication provided that you attribute the work to the Commonwealth and abide by the other licence terms.

Further information on the licence terms is available from https://creativecommons.org/licenses/by/4.0/

This publication should be attributed in the following way: © Commonwealth of Australia 2020

Use of the Coat of Arms

The Department of the Prime Minister and Cabinet sets the terms under which the Coat of Arms is used. Please refer to the Commonwealth Coat of Arms - Information and Guidelines publication available at http://www.dpmc.gov.au.

Contact us

This publication is available in hard copy or PDF format. All other rights are reserved, including in relation to any Departmental logos or trade marks which may exist. For enquiries regarding the licence and any use of this publication, please contact:

Director - Publishing and CommunicationsCommunications BranchDepartment of Infrastructure, Transport, Regional Development and CommunicationsGPO Box 594Canberra ACT 2601Australia

Email: publishing@infrastructure.gov.au Website: www.infrastructure.gov.au

Strategic Plan 2020 to 2025 1

I understand that quality healthcare is important to the residents of Christmas Island and the Cocos (Keeling) Islands. The Australian Government funds and operates the Indian Ocean Territories Health Service, investing in people, partnerships, training, equipment and infrastructure to provide critical healthcare to the residents of one of our most remote Australian communities.

Continuing to provide high quality patient-centred health services to the community remains a priority for the Australian Government. The values of the Health Service—Committed to service, Ethical, Respectful, Accountable—will continue to underpin our goal of keeping residents healthy for the whole of their lives.

Primary health care is the entry level to, and usually a person’s first encounter with, the health system. It includes diagnosis, health promotion and prevention, treatment, and management of acute and chronic conditions. Our goal is to deliver a holistic health service that supports physical, mental, social, spiritual and emotional health and wellbeing. The Health Service will also be a safe place for those in our community who may be experiencing trauma, anxiety, family violence, or who otherwise feel at risk.

The health needs of a community change over time and we must be responsive to those changes. The Health Service will have the systems, staff and infrastructure to identify new needs and respond in a timely manner.

This Strategic Plan outlines initiatives to support these goals and to continue to provide highquality, targeted and relevant health services. I look forward to working with you to achieve these goals and to support the communities of Christmas Island and the Cocos (Keeling) Islands.

The Hon Nola Marino MPAssistant Minister for Regional Development and Territories

2 Indian Ocean Territories Health Strategy

Strategic Plan 2020 to 2025 32 Indian Ocean Territories Health Strategy

Introduction

The Australian Government, through the Department of Infrastructure, Transport, Regional Development and Communications, funds and operates the Indian Ocean Territories Health (IOT) Service. A range of services are offered from facilities on Christmas Island and the Cocos (Keeling) Islands, including:

• primary healthcare, pathology, radiology, pharmacy and acute in-patient care

• public, community and child health programs

• aged care, including home and community care

• disability services

• accident and emergency care, patient assisted travel and emergency medical evacuation

• oral healthcare, and

• access to specialist medical care and allied healthcare.

These services are supplemented through a Service Delivery Arrangement with the Western Australian Department of Health, which provides for:

• regulatory, policy, governance and specialist medical advice

• in-hospital services and care in Western Australia, and

• mammography screening and assessment services through BreastScreen WA.

This Strategic Plan outlines the IOT Health Service’s commitments to the residents of the Indian Ocean Territories. It sets out our goals, objectives and aspirations for the next five years. It is also flexible, with capacity to adapt to changing health needs, a changing population, and a changing economic environment.

This Strategic Plan is informed by the PricewaterhouseCoopers Final Report on the Indian Ocean Territories Health Service 1, extensive consultation with the community and Health Advisory Groups and workshops with staff in the IOT Health Service. 2 It is supported by policies, procedures and facts sheets. 3

1 March 2019, available on the Department of Infrastructure, Transport, Regional Development and Communications’ website.2 May to September 20193 Available on the Department of Infrastructure, Transport, Regional Development and Communications’ website.

4 Indian Ocean Territories Health Strategy

Our Goal

The IOT Health Service will deliver high quality whole-of-life care to the community. We will deliver this through well-trained staff, appropriate and modern facilities and equipment, responding quickly to emerging and changing needs, and continual improvement. It will be supported by robust clinical governance arrangements, which are open and transparent, and feedback from the community. Delivery of services and care will target the diverse needs of the community, including cultural diversity.

Our goal is underpinned by our values

• Committed to service: professional, responsive, innovative, collaborative, caring

• Ethical: demonstrate leadership, trustworthy, act with integrity

• Respectful: culture, age, heritage, needs

• Accountable: open, transparent, share information, implement feedback

Strategic Plan 2020 to 2025 54 Indian Ocean Territories Health Strategy

Our Priorities

6 Indian Ocean Territories Health Strategy

PRIORITY ONEPREVENTATIVE HEALTH CARE, CHRONIC DISEASE AND MENTAL HEALTHWe will deliver health care to optimise and maintain the health of our community. Our work will prevent, treat and manage disease, support mental health and encourage healthy lifestyles.

We will

9 continually monitor advances in health care to ensure best practice in our support for patients with chronic disease and mental illness

9 work with patients and their families to deliver the care that is needed at a particular time, recognising that care for chronic disease and mental health will change over time

9 improve education and communication to inform and empower healthy choices, prevent chronic disease and reduce vaccine-preventable disease

9 promote understanding of mental health issues and their impacts, and provide choice in services to support mental health

9 work towards greater patient involvement in managing their own health needs

9 work closely with our community, and particularly our young people, to manage their mental health, build their understanding of the importance of a healthy lifestyle (food, exercise) and support safe sexual practices.

We will do this by

9 working closely with our professional colleagues to understand changes in treatments for chronic disease and mental illness, ensuring our staff are trained to deliver best-practice care, and using telehealth services for regular consultations, counselling and training

9 participating in activities to promote healthy outcomes, increasing understanding about the benefits of good health, and improving health literacy

9 exploring collaborations with medical research organisations, universities and hospitals to address issues which are unique to island and remote communities

9 clearly communicating services available to the community

9 ensuring our care is tailored to meet individual needs in close consultation with patients, their families and their carers

9 providing confidential, discreet and easily accessible support for patients experiencing mental illness

9 developing a strategy to address increasing rates of diabetes and kidney disease

9 monitoring emerging chronic diseases, mental illnesses and life-style related illnesses, developing timely responses and care solutions, and providing advice to the community

9 engaging with all community members to ensure we prevent disease or diagnose it early.

Strategic Plan 2020 to 2025 76 Indian Ocean Territories Health Strategy

PRIORITY TWOCARING FOR OUR SENIORSWe will provide high quality care to our seniors which responds to their changing needs, including in-home services, respite care and palliative care. Our aged care strategy will meet the different needs of our seniors on Christmas Island and the Cocos (Keeling) Islands.

We will

9 continually monitor advances in aged care to ensure best-practice in our support

9 work with the families of our seniors to deliver the care that is needed at a particular time, recognising the needs of seniors will change over time

9 respect and value the needs of our seniors, their culture and their connection to the community

9 provide patient focused palliative care, including for patients with dementia.

We will do this by

9 developing an aged care strategy which considers the need for dedicated aged care and respite facilities, and increased in-home care

9 clearly communicating services available, eligibility criteria for services, arrangements for funding and supporting policies

9 working individually with patients, their families and their carers to deliver a tailored care program

9 utilising ‘My Aged Care’ to mirror in-home aged care services provided on the mainland, and provide targeted training and support to nurses and health workers

9 working with local organisations, the Shire of Christmas Island, and the Shire of the Cocos (Keeling) Islands to deliver recreational and cultural and activities, and improve transport services

9 reviewing the program of visiting specialists annually to confirm it is adequately meeting the needs of our seniors

9 providing targeted training to health care workers to ensure they can meet the changing needs of our seniors as part of our strategy to recruit, train and retain a skilled workforce.

8 Indian Ocean Territories Health Strategy

PRIORITY THREESKILLED PEOPLEWe will ensure our staff are highly trained, responsive and committed to providing high qualitycare to the community. Our staff are valued and take pride in their work.

We will

9 recruit, develop and retain highly skilled staff, with a focus on those with experience working in remote communities

9 take pride in our work and provide the best quality care to our community

9 provide professional development and training opportunities for our staff, and support for their physical and mental wellbeing.

We will do this by

9 investing in staff training and improving development pathways for clinical and support staff

9 supporting student placements in clinical roles. We will work closely with the local high schools to develop work experience, school holiday and traineeship programs

9 encouraging medical students and student nurses to complete a rotation on Christmas Island or the Cocos (Keeling) Islands

9 ensuring continuity of care by reducing use of nursing and medical locums

9 strengthening our partnership with the Western Australian Department of Health, including to explore placements for staff to build expertise and gain experience in varying medical environments

9 ensuring we have a strong workforce plan

9 periodically reviewing our staffing model to ensure it provides the optimal combination of emergency, in-hospital and community care.

Strategic Plan 2020 to 2025 98 Indian Ocean Territories Health Strategy

PRIORITY FOURSAFETY, QUALITY AND INFRASTRUCTUREWe will provide facilities, equipment and infrastructure that are safe, meet national standards and are appropriate to provide high-quality health care. We will deliver care that is supported by robust policies, procedures and practices.

We will

9 maintain our accreditation under the National Safety and Quality Health Service Standards

9 strengthen our governance framework

9 meet, and aim to exceed, national health care standards

9 be supported by best-practice asset, financial, risk and Work Health and Safety management systems and policies.

We will do this by

9 implementing a Clinical Governance Framework, supported by the Indian Ocean Territories Health Service Governance Advisory Council and the Indian Ocean Territories Health Service Community Advisory Committee

9 ensuring a respectful workplace culture, completing regular workplace audits and complying with Work Health and Safety standards

9 delivering a high-quality, modern, efficient and reliable telehealth service

9 encouraging and continually reviewing consumer feedback to deliver improvements to our services and facilities

9 reviewing our management, IT and support systems and policies, and developing a strategy to address outcomes of the review

9 robust reporting, including an Annual Report to the community and monthly reports on operational and clinical outcomes to the executive of the Department of Infrastructure, Transport, Regional Development and Communications

9 collaborating with world-class universities on research to inform our approach to, and requests for, community health care, technology and infrastructure. We will seek to participate in research programs on tropical medicine and illnesses prevalent in remote communities.

10 Indian Ocean Territories Health Strategy

1533 hours of

disability support

provided

1602 hours of Home and Community Care support provided

1717 total visits to the IOTHS dental clinics including

530 dental check-ups

5454 appointments

with GPs for

1671 patients

1440 patients

seen at the Christmas Island Hospital

Emergency Department

24 seniors regularly participate in the Stay on Your Feet programs

2018–19 services

Strategic Plan 2020 to 2025 1110 Indian Ocean Territories Health Strategy

30 medical evacuations

665 Patient Assisted Travel Scheme

trips

422 X-rays taken29 health promotion activities conducted by the IOTHS